Prospective observational study for estimating the optimal Depth of insertion of endotracheal tube in orotracheal Intubation using ultrasound and clinical parameters (5-Point auscultation) in Indian population at tertiary care Hospital

Endotracheal intubation is routine procedure in general anaesthesia to maintain the oxygenation and ventilation. Appropriate depth of insertion of endotracheal intubation confirms the safety of patient from endobronchial intubation leading to single lung ventilation, atelectasis and too shallow placed endobronchial cuff will result in vocal cord injury. Among the various techniques such as X-Rays, fiber optic bronchoscopy, ultrasound etc. used to determine the correct depth of endotracheal tube insertion Ultrasound is noninvasive, safe and fairly accurate method.

Saline inflated cuff is visualized using ultrasound to confirm the correct endotracheal tube placement and depth of insertion. As length of trachea and distance from teeth to vocal cords varies in individuals a fixed depth or fixed mark on ETT may be inadequate and will vary with height and neck length. As suggested in some studies the proximal part of cuff should be 1.5 cm to 2.5 cm from vocal cords and at Tracheal ring T2 to T4 the ultrasound will be easy guide to determine the endotracheal tube cuff position.

Ultrasound can be used to determine the correct depth of ET cuff in Indian adult population and its relation to height, neck length.

Anthropometry of Individuals i.e. (Height and Neck Length) affect the optimal depth of insertion of Endotracheal tube.

The primary objective of this study is to determine the depth of insertion of Endotracheal tube using Ultrasound and Clinical parameters. Secondary is to find the correlation between the depth of insertion of ETT with height and neck length in Indian population.